CPT Code and Description 64490 (cervical or thoracic) or 64493 (lumbar or sacral) reports a single level injection performed with image guidance (fluoroscopy or CT). Procedures performed under ultrasound guidance are not covered. 64491 or 64494 describes a second...
Covered Services: a. Except for specific laboratory tests identified under non-covered services, the Division of Health Care Financing and Policy (DHCFP) reimburses organ or disease oriented panels, therapeutic drug assays, evocative/suppression testing, clinical...
Colonoscopy Billing Tips – CPT 45380, 45385 As a speaker at many national conferences, I find the question most frequently asked is, “What is the proper way to code a screening colonoscopy?” First, let’s talk about what is a screening colonoscopy. Physicians suggest a...
Employer Group waiver plan Employer Group Waiver Plans (EGWPs) are well-positioned solutions to help you keep costs down and offer valuable retiree benefits. An EGWP has financial benefits that significantly exceed current RDS payments. You should consider an EGWP if...
CREDENTIALING PROCESS FOR NEW PHYSICIANS Overview New physicians/providers must credential themselves, i.e., enroll and attest with the Payer’s network and authorized to provide services to patients who are members of the Payer’s plans. The credentialing process...
Source of Delays in the Credentialing Process: The credentialing process may get further delayed due to few primary causes. They are as follows: Poor response or planning: Many times the response from new physicians or even credentialed physicians for our requests of...
Reimbursement Guidelines Time Span Codes UnitedHealthcare will reimburse a CPT or HCPCS Level II code that specifies a time period for which it should be reported (e.g., weekly, monthly), once during that time period. The time period is based on sourcing from the AMA...
